﻿<%@ Page Language="C#" MasterPageFile="~/travel-insurance/proposalforms/TravelInsuranceProposalMasterPage.master" Async="true"
    Title="Travel Insurance - CompareXpress Singapore" AutoEventWireup="true" CodeFile="hsbc_proposal_form.aspx.cs"
    Inherits="travel_insurance_hsbc_proposal_form" %>

<%@ Register Src="~/controls/usrPhoneNo.ascx" TagName="usrPhoneNo" TagPrefix="uc1" %>
<%@ Register Src="~/controls/usrDate.ascx" TagName="usrDate" TagPrefix="uc2" %>
<%@ Register Src="~/controls/usrIdType.ascx" TagName="usrIdType" TagPrefix="uc3" %>
<%@ Register Src="~/controls/usrIdNumber.ascx" TagName="usrIdNumber" TagPrefix="uc4" %>
<%@ Register Src="~/controls/usrCompanyLogoByServices.ascx" TagName="usrCompanyLogoByServices"
    TagPrefix="uc5" %>
<%@ Register Src="~/controls/usrSalutation.ascx" TagName="usrSalutation" TagPrefix="uc6" %>
<%@ Register Src="~/controls/usrNationality.ascx" TagName="usrNationality" TagPrefix="uc7" %>
<%@ Register Src="~/controls/usrGender.ascx" TagName="usrGender" TagPrefix="uc8" %>
<%@ Register Src="~/controls/usrRelationship.ascx" TagName="usrRelationship" TagPrefix="uc9" %>
<%@ Register Src="~/controls/usrTraveller.ascx" TagName="usrTraveller" TagPrefix="uc10" %>
<%@ Register Src="~/controls/usrNoJS.ascx" TagName="usrNoJS" TagPrefix="ucNoJS" %>
<%@ Register Src="~/controls/usrCXAds.ascx" TagName="usrCXAds" TagPrefix="ucAds" %>
<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" runat="Server">

    <script src="../../controls/CE_Date.js" type="text/javascript"></script>

    <script src="../../controls/IdNumber.js" type="text/javascript"></script>

    <script src="../../includes/PostCode.js" type="text/javascript"></script>

    <div id="container">
    
        <div id="nav_top">
            <div class="left pad_8yr">
                <a href="/travel-insurance/TAresultsquotesOne.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a></div>
            <div class="right pad_8yr">
                <img src="/images/forms_proposal/nav/logo_comparexpress.png" alt="CompareXpress" /></div>
        </div>
        
        <ucNoJS:usrNoJS ID="usrNoJS1" runat="server" />
        <asp:ScriptManager ID="ScriptManager1" runat="server"></asp:ScriptManager>       
        <div id="divContent">
            <div id="contentBody">
                <div id="header">
                    <div class="seperator"></div>
                    <div class="right" style="width: 240px">
                        <div class="quotesum_button">
                            <img src="/images/forms_proposal/button/quotesum.png" width="240" height="73" alt="Quote Summary" /></div>
                    </div>
                    <h1>Online Travel Insurance Proposal Form - <asp:Label ID="lblProvider" runat="server"></asp:Label></h1>
                    <div class="seperator"></div>
                    <div class="quotesum">
                        <div class="top"></div>
                        <div id="divQuoteSummery" class="body pad_15x">
                            <!-- QUOTE SUMMARY | Start -->
                            <div class="w21per left pad_25xr">
                                <h1>Quote Reference Number</h1>
                                <p><asp:Label ID="lblQref" runat="server"></asp:Label></p>
                                <h1>Type of Travel:</h1>
                                <p>
                                    <asp:Label ID="lblCoverageType" runat="server"></asp:Label><asp:Label ID="lblCover" runat="server" 
                                        Visible="false"></asp:Label><asp:Label ID="lblCoverage" runat="server" Visible="false"></asp:Label>
                                </p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>Country Traveling to (one or furthest):</h1>
                                <p><asp:Label ID="lblDestination" runat="server"></asp:Label><asp:Label ID="lblTrip" runat="server" Visible="false"></asp:Label></p>
                                <h1>Period of Insurance:</h1>
                                <p>
                                    <asp:Label ID="lblPeriodOfCoverage" runat="server"></asp:Label>
                                    <asp:Label ID="lblDuration" runat="server" Visible="false"></asp:Label><asp:Label
                                        ID="lblStart" runat="server" Visible="false"></asp:Label><asp:Label ID="lblEnd" runat="server"
                                            Visible="false"></asp:Label>
                                </p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>Type of Plan:</h1>
                                <p>
                                    <asp:Label ID="lblPolicyType" runat="server"></asp:Label><asp:Label ID="lblAdultAge"
                                        runat="server" Visible="false"></asp:Label><asp:Label ID="lblChildAge" runat="server"
                                            Visible="false"></asp:Label>
                                </p>
                                <h1>No. of Traveller/s:</h1>
                                <p><asp:Label ID="lblNoOfTravellers" runat="server"></asp:Label><input id="inNoOfTravellers" runat="server" type="hidden" /></p>
                            </div>
                            <script type="text/javascript">
                                IncreaseProgress(20);
                            </script>
                            <div class="w21per left pad_25xr">
                                <h1>&nbsp;</h1>
                                <p>&nbsp;</p>
                                <h1>Total Premium (w/ GST):</h1>
                                <p><asp:Label ID="lblTotalPremium" runat="server"></asp:Label></p>
                            </div>
                            <!-- QUOTE SUMMARY | End   -->
                        </div>
                        <div class="bottom"></div>
                    </div>
                </div>
                
                <div class="seperator"></div>
                
                <script type="text/javascript">
                    IncreaseProgress(25);
                </script>
                
                <div id="body"></div>
                <div id="divValidationSummary">
                    <asp:ValidationSummary ID="vstravelinsurance" runat="server" CssClass="errorSummary"
                        ValidationGroup="travel_insurance" HeaderText="Oops please complete the form" />
                </div>
                <div class="form">
                    <div class="top">
                        <div class="left">
                            <div class="pad_10t pad_35xl white">Online Travel Insurance Proposal Form</div>
                        </div>
                        <div class="right"></div>
                    </div>
                    <div class="body">
                        <div class="inner">
                            <div class="pad_20x10y">
                                <div class="norm">
                                    <div class="top_t"></div>
                                    <div class="body">
                                        <div class="pad_15x">
                                            <p>
                                                Pursuant to Section 25(5) of the Insurance Act (Cap. 142), or any subsequent amendments
                                                thereof, you are to disclose in this Application, fully and faithfully, all the
                                                facts you know or ought to know, otherwise the Policy issued hereunder may be void
                                                and you may receive nothing from the Policy.<br />
                                                <br />
                                                <b>Important</b>: Main insured must be a Singapore resident, Singapore PR or Work
                                                Permit Holder and be at least 18 years of age.</p>
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                                
                                <div class="seperator"></div>

                                <div class="hilite">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x">
                                        <h1>Customer Personal Details</h1>
                                        <div class="seperator"></div>
                                        <div class="w43per left">
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Salutation:</div>
                                                <div class="left">
                                                   <uc6:usrSalutation ID="ddlSalutation" runat="server" ValidationGroup="travel_insurance" />
                                                </div>                                                
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Surname:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtSurname" runat="server" Width="200px"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvSurname" runat="server" ControlToValidate="txtSurname"
                                                        CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Given/First Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtFirstname" runat="server" Width="200px"></asp:TextBox>
                                                    <asp:HyperLink ID="hplEditProfile" Visible="false" NavigateUrl="~/User/EditProfile.aspx?redir=~/travel-insurance/applicants_details.aspx"
                                                        Font-Size="Smaller" Text="Edit Profile" runat="server"></asp:HyperLink>
                                                    <asp:RequiredFieldValidator ID="rfvFirstname" runat="server" ControlToValidate="txtFirstname"
                                                        CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>                            
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> E-mail:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtEmailAddress" runat="server" Width="200px"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvEmailAddress" runat="server" ControlToValidate="txtEmailAddress"
                                                        Display="Dynamic" CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revEmailAddress" runat="server" ControlToValidate="txtEmailAddress"
                                                        CssClass="validationErrorControl" ErrorMessage="" ValidationExpression="\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*"
                                                        ValidationGroup="travel_insurance"></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Nationality:</div>
                                                <div class="left">
                                                    <uc7:usrNationality ID="ddlNationality" runat="server" ErrorMessage="" ValidationGroup="travel_insurance" />
                                                </div>
                                            </div>
                                        </div>
                                        <div class="w56per left">
                                            <asp:UpdatePanel ID="UpdatePanel1" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPostCode">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Postcode:
                                                        </div>
                                                        <asp:TextBox ID="txtPostCode" size="8" onkeypress="restrictToNumbers(event)" AutoPostBack="true"
                                                            OnTextChanged="txtPostCode_TextChanged" runat="server" MaxLength="6" Width="80px"></asp:TextBox>
                                                        <asp:ImageButton ID="ibtPostCode" runat="server" CssClass="button" align="absmiddle"
                                                            OnClick="ibtPostCode_Click" Width="108" ValidationGroup="PostCode" AlternateText="Get Address"
                                                            ImageUrl="~/images/forms_proposal/button/getaddress.png" />
                                                        <asp:UpdateProgress runat="server" ID="uplUpProgress" DisplayAfter="500">
                                                            <ProgressTemplate>
                                                                <span style="position: absolute; text-align: right; width: 390px;">
                                                                    <img src="../../images/loading7.gif" id="ldPostCode" alt="loading" />
                                                                </span>
                                                            </ProgressTemplate>
                                                        </asp:UpdateProgress>
                                                        <asp:RequiredFieldValidator ID="rfvPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                        <asp:RequiredFieldValidator ID="rfvPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                    </div>
                                                    <div runat="server" visible="false" id="divAddressList">
                                                        <div class="h10"></div>
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            Please choose your address
                                                        </div>
                                                        <asp:DropDownList ID="ddlAddressList" Width="320px" AutoPostBack="true" runat="server" OnSelectedIndexChanged="ddlAddressList_SelectedIndexChanged">
                                                        </asp:DropDownList>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                            <div class="h10"></div>
                                            <div id="divUnitNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Unit Number:
                                                </div>
                                                <asp:TextBox ID="txtUnit1" MaxLength="10" runat="server" size="8"></asp:TextBox>-
                                                <asp:RequiredFieldValidator ID="rfvUnit1" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtUnit1"></asp:RequiredFieldValidator>
                                                <asp:TextBox ID="txtUnit2" MaxLength="10" runat="server" size="8"></asp:TextBox>
                                                <asp:RequiredFieldValidator ID="rfvUnit2" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtUnit2"></asp:RequiredFieldValidator>
                                            </div>
                                            <div class="h10"></div>
                                            <asp:UpdatePanel ID="UpdatePanel2" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPCAddress">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Address:
                                                        </div>
                                                        <span id="divAddress"></span>
                                                        <asp:TextBox ID="txtAddress" runat="server" TextMode="MultiLine" MaxLength="120"
                                                            Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvAddress" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtAddress"></asp:RequiredFieldValidator>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Gender:</div>
                                                <div class="left">
                                                    <uc8:usrGender ID="ddlGender" ValidationGroup="travel_insurance" runat="server" IsEnabled="true" />
                                                </div>
                                            </div>
                                            <div style="display: none">
                                                <asp:TextBox ID="txtSalGenderValid" Text="Valid" runat="server"></asp:TextBox>
                                                <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtSalGenderValid"
                                                    ValidationGroup="travel_insurance" ID="csvSalGender" ClientValidationFunction="CheckSalGenderValid"
                                                    OnServerValidate="CheckSalGenderValid" runat="server" ErrorMessage="Salutation and gender do not match."
                                                    Text=""></asp:CustomValidator>
                                            </div>
                                        </div>
                                        <div class="clear"></div>
                                        <div class="h10"></div>
                                        <div style="border: 1px solid #ccc; width: 912px; background: #d2d2d2;">
                                            <div class="h10"></div>
                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                Contact Info:</div>
                                            <div class="w190 note left">
                                                <span class="red">*</span> Mobile Number<br />
                                                <uc1:usrPhoneNo ID="txtMobileNo" IsEnabled="true" IsRequired="true" PhoneNoRequireErrorMessage="Require mobile number."
                                                    PhoneNoErrorMessage="Mobile phone number should 8 digits." PhoneNoValidErrorMessage="Invalid mobile phone number."
                                                    runat="server" ValidationGroup="travel_insurance" />
                                            </div>
                                            <div class="w190 note left">
                                                Home Phone Number<br />
                                                <uc1:usrPhoneNo ID="txtResidentialPhoneNo" runat="server" ValidationGroup="travel_insurance"
                                                    IsRequired="False" PhoneNoValidErrorMessage="Invalid home phone number." />
                                            </div>
                                            <div class="w190 note left">
                                                Office Phone Number<br />
                                                <uc1:usrPhoneNo ID="txtOfficeNo" runat="server" ValidationGroup="travel_insurance"
                                                    IsRequired="False" />
                                            </div>
                                            <div class="h10"></div>
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                                
                                <div class="seperator"></div>

                                <script type="text/javascript">
                                    IncreaseProgress(40);
                                </script>
                                
                                <div class="hilite" id="divTravellersInsured">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x" id="divInsured">
                                        <h1>Insured Details</h1>
                                        <div class="seperator"></div>
                                        <div id="divIndividual" runat="server">                                 
                                            <div class="w43per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Insured:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNameOfInsured" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNameOfInsured" runat="server" ControlToValidate="txtNameOfInsured"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOB" runat="server" ValidationGroup="travel_insurance" IsRequired="True" IsEnabled="false" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPass" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPass" runat="server" ControlToValidate="txtNRICPass"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Gender:</div>
                                                    <div class="left">
                                                        <uc8:usrGender ID="ddlGenderIndividual" ValidationGroup="travel_insurance" runat="server" />
                                                    </div>
                                                </div>
                                            </div>
                                        </div> 
                                        <div id="divWithspouse" runat="server">                                 
                                            <div class="w43per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Insured:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtInsured" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvInsured" runat="server" ControlToValidate="txtInsured"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBinsured" runat="server" ValidationGroup="travel_insurance" IsRequired="True" IsEnabled="false" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassInsured" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassInsured" runat="server" ControlToValidate="txtNRICPassInsured"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Gender:</div>
                                                    <div class="left">
                                                        <uc8:usrGender ID="ddlGenderWithSpouse" ValidationGroup="travel_insurance" runat="server" />
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="w56per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Partner/Spouse:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtSpouse" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvSpouse" runat="server" ControlToValidate="txtSpouse"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBSpouse" runat="server" ValidationGroup="travel_insurance" IsRequired="True" IsEnabled="false" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassSpouse" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassSpouse" runat="server" ControlToValidate="txtNRICPassSpouse"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Gender:</div>
                                                    <div class="left">
                                                        <uc8:usrGender ID="ddlGenderSpouse" ValidationGroup="travel_insurance" runat="server" />
                                                    </div>
                                                </div>
                                                <div style="display: none;">
                                                    <div>
                                                        <asp:TextBox ID="txtNRICwidSpouse" runat="server" Text="Valid"></asp:TextBox>
                                                        <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtNRICwidSpouse"
                                                            ValidationGroup="travel_insurance" ID="csvNRIC" ClientValidationFunction="Check2NRICValid"
                                                            OnServerValidate="Check2NRICValid" runat="server" ErrorMessage="Applicant IC/Passport and Spouse IC/Passport is the same."
                                                            Text=""></asp:CustomValidator>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <div id="divFamily" runat="server">                                 
                                            <div class="w43per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Insured:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtInsuredFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvInsuredFamily" runat="server" ControlToValidate="txtInsuredFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBInsuredFamily" runat="server" ValidationGroup="travel_insurance" IsRequired="True" IsEnabled="false" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassInsuredFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassInsuredFamily" runat="server" ControlToValidate="txtNRICPassInsuredFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Gender:</div>
                                                    <div class="left">
                                                        <uc8:usrGender ID="ddlGenderFamily" ValidationGroup="travel_insurance" runat="server" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div style="display:none;">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Number of children travelling:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNoOfChild" runat="server" Width="200px" Text="0"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNoOfChild" runat="server" ControlToValidate="txtNoOfChild"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                        <asp:TextBox ID="txtNoOfAdult" runat="server" Width="200px" Text="0"></asp:TextBox>
                                                        <asp:TextBox ID="txtNoOfTravellers" runat="server" Width="200px" Text="0"></asp:TextBox>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="w56per left" runat="server" id="divFamilySpouse" visible="false">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Partner/Spouse:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtSpouseFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvSpouseFamily" runat="server" ControlToValidate="txtSpouseFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBSpouseFamily" runat="server" ValidationGroup="travel_insurance" IsRequired="True" IsEnabled="false" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassSpouseFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassSpouseFamily" runat="server" ControlToValidate="txtNRICPassSpouseFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Gender:</div>
                                                    <div class="left">
                                                        <uc8:usrGender ID="ddlGenderSpouseFamily" ValidationGroup="travel_insurance" runat="server" />
                                                    </div>
                                                </div>
                                                <div style="display: none;">
                                                    <asp:TextBox ID="txtNRICwithFamily" runat="server" Text="Valid"></asp:TextBox>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtNRICwithFamily"
                                                        ValidationGroup="travel_insurance" ID="cvNRICfamily" ClientValidationFunction="Check2NRICValidFamily"
                                                        OnServerValidate="Check2NRICValidFamily" runat="server" ErrorMessage="Applicant IC/Passport and Spouse IC/Passport is the same."
                                                        Text=""></asp:CustomValidator>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="clear"></div>
                                    </div>
                                    <div class="bottom"></div>
                                    
                                </div><div class="seperator"></div>
                                <script type="text/javascript">
                                    IncreaseProgress(50);
                                </script>
                                <asp:Panel ID="pnlAdultsParticulars" runat="server" Width="100%">
                                <div class="hilite" id="divAdults">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Additional Adult's Details</h1>
                                            <asp:Panel ID="pnlAdult1" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Adult 1</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divAdultName1">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtAdultName1" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvAdultName1" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtAdultName1"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revAdultName1" runat="server" ControlToValidate="txtAdultName1"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlAdultDOB1" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlAdultIdNumber1" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlAdult2" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Adult 2</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divAdultName2">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtAdultName2" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvAdultName2" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtAdultName2"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revAdultName2" runat="server" ControlToValidate="txtAdultName2"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlAdultDOB2" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlAdultIdNumber2" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>
                                <script type="text/javascript">
                                    IncreaseProgress(60);
                                </script>
                                <asp:Panel ID="pnlChildsParticulars" runat="server" Width="100%">
                                <div class="hilite" id="divChilds">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Child's Details</h1>
                                            <asp:Panel ID="pnlChild1" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 1</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName1">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName1" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName1" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName1"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName1" runat="server" ControlToValidate="txtChildName1"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB1" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber1" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc8:usrGender ID="ddlGenderChild1" ValidationGroup="travel_insurance" runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild2" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 2</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName2">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName2" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName2" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName2"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName2" runat="server" ControlToValidate="txtChildName2"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB2" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber2" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc8:usrGender ID="ddlGenderChild2" ValidationGroup="travel_insurance" runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild3" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 3</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName3">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName3" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName3" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName3"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName3" runat="server" ControlToValidate="txtChildName3"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB3" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber3" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc8:usrGender ID="ddlGenderChild3" ValidationGroup="travel_insurance" runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild4" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 4</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName4">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName4" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName4" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName4"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName4" runat="server" ControlToValidate="txtChildName4"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB4" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber4" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc8:usrGender ID="ddlGenderChild4" ValidationGroup="travel_insurance" runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild5" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 5</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName5">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName5" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName5" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName5"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName5" runat="server" ControlToValidate="txtChildName5"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB5" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber5" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc8:usrGender ID="ddlGenderChild5" ValidationGroup="travel_insurance" runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild6" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 6</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName6">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName6" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName6" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName6"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName6" runat="server" ControlToValidate="txtChildName6"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB6" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber6" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc8:usrGender ID="ddlGenderChild6" ValidationGroup="travel_insurance" runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>

                                <script type="text/javascript">
                                    IncreaseProgress(70);
                                </script>
                                
                                <div class="hilite" style="display: " id="divPaymentModeHeader">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x" id="divPaymentMode">
                                        <h1>Payment Mode</h1>
                                        <div class="seperator"></div>
                                        I / We authorised <b>HSBC Insurance (Singapore) Pte. Limited</b> to debit the premium
                                        amount due in connection with above insurance policy to my nominated Credit Card
                                        Account. Where a third party Credit Card is used, I declared that the cardholder
                                        has authorised and consented to its use.
                                        <div class="seperator"></div>
                                        <div id="divCreditcard" style="display: ;">
                                            <div id="divNameoftheCard">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Cardholder's Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtNameoftheCard" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvNameoftheCard" ControlToValidate="txtNameoftheCard"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divIssuingBank">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Issuing Bank:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtIssuingBank" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvIssuingBank" ControlToValidate="txtIssuingBank"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardNo">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Credit Card Number:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtCardNo1" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo2" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo3" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo4" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo1" ControlToValidate="txtCardNo1" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo1" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo1"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo2" ControlToValidate="txtCardNo2" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo2" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo2"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo3" ControlToValidate="txtCardNo3" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo3" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo3"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo4" ControlToValidate="txtCardNo4" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo4" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo4"></asp:RegularExpressionValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCreditCardValid"
                                                        ValidationGroup="travel_insurance" ID="csvCreditCardValid" runat="server" ErrorMessage="Credit Card number not valid."
                                                        Text="" OnServerValidate="csvCreditCardValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCreditCardValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardExpiry">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Expiry Date:</div>
                                                <div class="left">
                                                    <asp:DropDownList ID="ddlCardExpiryMonth" runat="server">
                                                        <asp:ListItem Selected="True" Value="-1">mm</asp:ListItem>
                                                        <asp:ListItem Value="01">01</asp:ListItem>
                                                        <asp:ListItem Value="02">02</asp:ListItem>
                                                        <asp:ListItem Value="03">03</asp:ListItem>
                                                        <asp:ListItem Value="04">04</asp:ListItem>
                                                        <asp:ListItem Value="05">05</asp:ListItem>
                                                        <asp:ListItem Value="06">06</asp:ListItem>
                                                        <asp:ListItem Value="07">07</asp:ListItem>
                                                        <asp:ListItem Value="08">08</asp:ListItem>
                                                        <asp:ListItem Value="09">09</asp:ListItem>
                                                        <asp:ListItem Value="10">10</asp:ListItem>
                                                        <asp:ListItem Value="11">11</asp:ListItem>
                                                        <asp:ListItem Value="12">12</asp:ListItem>
                                                    </asp:DropDownList>
                                                    <asp:DropDownList ID="ddlCardExpiryYear" runat="server"></asp:DropDownList>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryMonth" ControlToValidate="ddlCardExpiryMonth"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" InitialValue="-1" Text=""
                                                        CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryYear" ControlToValidate="ddlCardExpiryYear"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" InitialValue="-1" Text=""
                                                        CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCCExpiredValid"
                                                        ValidationGroup="travel_insurance" ID="csvCCExpiredValid" runat="server" ErrorMessage="Credit Card expire not valid."
                                                        Text="" OnServerValidate="csvCCExpiredValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCCExpiredValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardType">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Type:</div>
                                                <div class="left">
                                                    <span id="divVisa">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoVisa"
                                                            runat="server" GroupName="cardtype" />
                                                        &nbsp;<asp:Label class="pad_10xr" ID="lblVisa" runat="server" Text="VISA"></asp:Label>
                                                    </span>
                                                    <span id="divMasterCard">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoMasterCard"
                                                            runat="server" GroupName="cardtype" />
                                                        &nbsp;<asp:Label ID="lblMasterCard" runat="server" Text="MasterCard"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtCardType" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvCardType" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtCardType" ValidationGroup="travel_insurance"
                                                        Text=""></asp:RequiredFieldValidator>
                                                    <div class="clear"></div>
                                                    <em class="note">(Only VISA or Master Credit Card is acceptable for premium payment)</em>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="seperator">
                                        </div>
                                        By signing this proposal form, I am aware that any refund will be paid by cheque
                                        the Insured/Policyholder. <b>HSBC Insurance (Singapore) Pte. Limited</b> will consider
                                        all declared information as true and correct. This Credit Card payment is subject
                                        to the terms of the Credit Card Agreement.
                                    </div>
                                    <div class="bottom"></div>
                                </div>

                                <div class="seperator"></div>
                                
                                <script type="text/javascript">
                                    IncreaseProgress(80);
                                </script>
                        
                                <div class="norm" id="divDeclarationHeader">
                                    <div class="top">
                                    </div>
                                    <div class="body">
                                        <div class="pad_15x">
                                            <h1>Declaration</h1>
                                            <div class="seperator"></div>
                                            <div>
                                                <p>I/We warrant that I/we have not been previously declined for similar class of insurance
                                                    cover by HSBC Insurance or any other insurance companies.</p>
                                                <div class="h7"></div>
                                                <p>Further, I/we declare that:</p>
                                                <div class="h7"></div>
                                                <p>1. I am a Singapore resident, Singapore PR or Work Permit Holder; &nbsp;&nbsp;&nbsp;&nbsp;<span
                                                    style="cursor: pointer;" onclick="showhide('divDeclaration');" class="form_i_cap">More Info
                                                    <img id='imgDeclaration' alt="Click to show/hide More Info" border="0" src="../../images/icons/sort_down.GIF" /></span></p>
                                            </div>
                                        </div>
                                        <div style="display: " id="divDeclaration" class="pad_15x">
                                            <div class="h7"></div>
                                            <p>2. I/we am/are within the eligible age of coverage;</p>
                                            <div class="h7"></div>
                                            <p>3. I/we am/are fit for travel, am/are in good health and am/are not travelling contrary
                                                to the advice of a medical practitioner, or for the purpose of obtaining medical
                                                treatment;</p>
                                            <div class="h7"></div>
                                            <p>4.I/We am/are not travelling against any travel advice announced, distributed, or
                                                otherwise communicated by the Singapore Government and/or the government of other
                                                countries or territories whether relating to actual or threatened riots, strike
                                                or civil commotion, war or warlike situation, health threatening situations, impending
                                                natural disasters or events of similar nature. If I/we proceed to travel to any
                                                such country or territory despite such advice having been announced, distributed
                                                or otherwise communicated prior to the commencement of my/our trip (regardless whether
                                                I/we had actual notice of the advice), I/we accept that I/we may not be covered
                                                for any direct or indirect losses or claims arising or resulting from such events
                                                from the date of the advice UNLESS the Trip had commenced prior to the advice being
                                                announced, distributed or otherwise communicated (with the exception of war which
                                                remains a policy exclusion); and</p>
                                            <div class="h7"></div>
                                            <p>5. I/we agree that information will be used, stored, transferred to or exchanged
                                                with such persons (whether situated within or outside of Singapore) that HSBC may
                                                consider necessary, including any member of the HSBC Group for any purpose in connection
                                                with promoting, improving and furthering the provision of financial services to
                                                me/us and/or for other purposes. I/we agree that where HSBC considers necessary
                                                or appropriate, it may transfer data, details or information to any appointed service
                                                provider (whether situated in or outside Singapore), under conditions of confidentiality
                                                imposed on such service providers, for the purpose of data processing or providing
                                                any service on HSBC’s behalf. The appointed service providers may be required by
                                                law to disclose information received from HSBC to third parties. Such circumstances
                                                include the service providers being compelled to disclose information pursuant to
                                                a court order, police investigations and criminal prosecutions for tax evasion or
                                                other offences.</p>
                                            <div class="h7"></div>
                                            <p>6. I/We agree to accept the terms and conditions governing this Policy (available
                                                on the website)</p>
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>

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                                <div class="seperator"></div>
                                
                                <div class="center align_center" id="divFormButtons">
                                    <asp:ImageButton ID="ibtSubmit" runat="server" ValidationGroup="travel_insurance"
                                        OnClientClick="LoadValidationErrorCss();CheckOptionValidationCss();" ImageUrl="~/images/forms_proposal/button/submit.png"
                                        OnClick="ibtSubmit_Click" class="button" />
                                    <asp:Label ID="lblMessage" runat="server" ForeColor="Red"></asp:Label>
                                    <div class="note">
                                        <img src="/images/forms_proposal/icon/warning.png" width="21" height="18" alt="Note"
                                            style="vertical-align: middle; padding-bottom: 3px" />
                                        <strong>Note</strong>, by clicking on the SUBMIT button you agree to our Website's
                                        <a href="../../terms/Terms.aspx" target="_blank">Terms &amp; Conditions</a>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="bottom"></div>
                    </div>
                </div>
                <div class="seperator"></div>
            </div>
        </div>
    </div>
    
    <div id="footer">
        <div id="nav_bottom" class="pad_7t">
            <div class="left pad_8yr">
                <a href="/travel-insurance/TAresultsquotesOne.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a>
            </div>
            <div class="right pad_8yr">
                <a href="#" onClick="window.print()"><img src="/images/forms_proposal/button/print.png" alt="Print" /></a>
            </div>
        </div>
    </div>
    
    <script type="text/javascript">
        //<![CDATA[
        IncreaseProgress(100);
        HideLoading();
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    </script>
        
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        function ShowHideDiv(divName, varOnOff) {
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                document.getElementById(divName).style.display = "";
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                document.getElementById(divName).style.display = "none";
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        }


        function CheckOptionValidationCss() {
            CheckCardTypeValidationCss();

        }

        function CheckValidationCss(divYes, divNo, ctrlText, valCtrl) {
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        function CheckValidationCssThree(div1, div2, div3, ctrlText, valCtrl) {
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        function CheckCardTypeValidationCss() {
            CheckValidationCss('divVisa', 'divMasterCard', '<%=txtCardType.ClientID%>', '<%=rfvCardType.ClientID%>');
        }

        function ValCheckCardType(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtCardType.ClientID%>");
            txtCtrl.value = "1";
        }

        function Check2NRICValid(source, arguments) {
            var ddlicpass = document.getElementById('<%=txtNRICPassInsured.ClientID%>');
            var appicpass = ddlicpass.value;

            var ddlspouseicpass = document.getElementById('<%=txtNRICPassSpouse.ClientID%>');
            var spouseicpass = ddlspouseicpass.value;

            var result = true;
            //alert(applicantNRIC + ' ' + spouseNRIC);

            if (appicpass == spouseicpass && appicpass != '' & spouseicpass != '') {
                result = false;
            }
            else {
                result = true;
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            if (result == false) {
                ddlicpass.style.backgroundColor = '#fcc';
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                ddlspouseicpass.style.border = '';

            }
            arguments.IsValid = result;
        }

        function Check2NRICValidFamily(source, arguments) {
            var ddlicpass = document.getElementById('<%=txtNRICPassInsuredFamily.ClientID%>');
            var appicpass = ddlicpass.value;

            var ddlspouseicpass = document.getElementById('<%=txtNRICPassSpouseFamily.ClientID%>');
            var spouseicpass = ddlspouseicpass.value;

            var result = true;

            if (appicpass == spouseicpass) {
                result = false;
            }
            else {
                result = true;
            }

            if (result == false) {
                ddlicpass.style.backgroundColor = '#fcc';
                ddlicpass.style.border = 'Solid 1px #f00';
                ddlspouseicpass.style.backgroundColor = '#fcc';
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                ddlspouseicpass.style.border = '';

            }
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        }

        function showhide(el) {

            el = document.getElementById(el);
            el.style.display = (el.style.display == "none") ? "block" : "none";

        }

        window.onload = function() {
            showhide('divDeclaration');
            //showhide('divPaymentMode');
            //showhide('divInsured');

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        function restrictToNumbers(e) {
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            try {
                var _pcode = document.getElementById('<%=txtPostCode.ClientID%>').value;
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                    alert('Postal code length must be 6 numbers value.');
                    document.getElementById('<%=txtAddress.ClientID%>').value = '';
                    return false;
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                alert(e.toString());
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            try {
                var srcTable = $("#divAddress").empty();
                var txtAddress = document.getElementById('<%=txtAddress.ClientID%>');
                if (json == null) {
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                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }
                if (json.length == 0) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }

                var tbl = $("<table width='50%'>");

                var tbody = $("<tbody>");
                var no = 1;
                for (var i = 0; i < json.length; i++) {
                    var trow = $("<tr>"), rec = json[i];
                    if (rec.t != null) {

                        var ctn = rec.t + "<br>" + rec.a;

                        //$("<td>").text(no).data("col", 1).appendTo(trow);
                        $("<td>").html(ctn).data("col", 2).appendTo(trow);
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                            txtAddress.value = rec.t + "\n" + rec.a;
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                        else {
                            txtAddress.value += "\n\n" + rec.t + "\n" + rec.a;
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                        no++;
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                    trow.appendTo(tbody);
                }
                tbody.appendTo(tbl);
                //alert(srcTable);
                tbl.appendTo(srcTable);
            }
            catch (e) {
                alert(e.toString());
            }
        }
        
        function PostCodeChange() {
            document.getElementById('divAddress').innerHTML = "Your postcode changed.";
            document.getElementById('divAddress').style.display = 'none';
            document.getElementById('<%=txtAddress.ClientID%>').innerHTML = "Your postcode changed.";
        }




        function CheckSalGenderValid(source, arguments) {
            var ctrlsal = document.getElementById('<%=ddlSalutation.ClientID%>' + '_ddlSal');
            var ctrlgender = document.getElementById('<%=ddlGender.ClientID%>' + '_ddlGender');

            var sal = ctrlsal.value;
            var gender = ctrlgender.value;
            var result = true;
            if (gender == 'M') {
                if (sal == 'Ms' || sal == 'Miss' || sal == 'Mdm' || sal == 'Mrs') {
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                    result = false;
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                ctrlgender.style.backgroundColor = '#fcc';
                ctrlgender.style.border = 'Solid 1px #f00';
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                ctrlsal.style.backgroundColor = '';
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                ctrlgender.style.backgroundColor = '';
                ctrlgender.style.border = '';
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            arguments.IsValid = result;
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        var hookAVal = false;
        function HookSalValidation() {
            if (hookAVal == false) {
                prefix = "<%=ddlSalutation.ClientID%>";
                var ddlSal = prefix + "_ddlSal";
                prefix = "<%=ddlGender.ClientID%>";
                var ddlGender = prefix + "_ddlGender";
                var valCtrl = "<%=csvSalGender.ClientID%>";
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                ValidatorHookupControlID(ddlGender, document.getElementById(valCtrl));
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